M. Elizabeth Oates, MD Rosenbaum Endowed Chair of Radiology Professor of Radiology & Medicine Chair, Department of Radiology Chief, Division of

Transcription

1 Unconscious Bias in Faculty Recruitment: Relevance to Radiology M. Elizabeth Oates, MD Rosenbaum Endowed Chair of Radiology Professor of Radiology & Medicine Chair, Department of Radiology Chief, Division of Nuclear Medicine & Molecular Imaging

2 Disclosure In February 2016, I completed a 2-day Cook Ross train-the-trainer course and have conducted a dozen or so Unconscious Bias workshops for College of Medicine chairs, center directors, and faculty.

3 Learning Objectives Define Unconscious Bias (UB) Understand relationship to diversity & inclusion Develop strategies to mitigate inherent individual & organizational biases that impact search process Apply strategies to recruit best faculty into Radiology

4 Diversity Important to all organizations Fosters creativity & innovation Promotes adaptability for change Reflects student body, patient population, community at large By managing UB, develop strategies to promote/support diversity/inclusion & empower search process to recruit best talent Different lures attract different fish

5 2016 ACR Survey Results: Gender Distribution of Workforce Female 21.4% 100% Male Female 26% 26% 22% 16% 11% Male 78.6% 50% 0% 74% 74% 78% 84% 89% Under to to to 65 Over 65 No significant changes from 2015 Courtesy of Edward Bluth, MD, Chair, ACR Commission on Human Resources

6 Radiology Pipeline: Diversity-Challenged Lightfoote et al, JACR, 2014

7 The Movie Theater

8 Introduction to Unconscious Bias (UB) Your reaction? Leave or sit down? Psychosocial demonstration of UB Philanthropic motorcycle club of doctors, lawyers, businessmen, judges, etc. By understanding & managing UB, open up larger pool of potential talent for recruitment

9 Definition: Conscious (Explicit) Bias Perceptions about individual/group on conscious level Preference for working with younger vs. older, men vs. women Sense threat => racial/ethnic profiling Fully aware, in control Knowingly conceal for social/political correctness

10 Definition: Implicit (Unconscious) Bias Pervasive tendency/inclination deeply rooted in unconscious feelings/attitudes/assumptions (stereotypes) about groups of people (race, age, ethnicity, appearance) developed over lifetime (personal experiences, media) Influences decisions/actions automatically/ unconsciously, w/o awareness/intent/questioning Associations => response ( gut reaction ) Favoring/valuing one group over another Eastern KY/Appalachia: regional accent/where from

11 Biases: Both Favorable & Unfavorable Examples of MEO s: Neg: Men who wear white socks with business attire Pos: Non-smokers, no piercings, no (visible) tattoos Neg: Construction workers (taunted F college students) Pos: Equestrians (youngest daughter) Neg: Names (bully, obnoxious/disruptive faculty) Pos: Names (family member, friend, own name!) YOUR EXAMPLES? Be honest.

12 Bias: Effect on Employability/Earnings Randomized, double-blind study of 127 M & F science faculty from research-intensive universities rated same application of student applying for laboratory manager position --- catch: M vs F name John rated 4/7; Jennifer as 3.3/7 Salary to John, $30,328; to Jennifer, $26,508 John more favorably as one to hire for laboratory/mentee Jennifer less competent, less likely hired Female professors as biased as male professors! Dr. Jo Handelsman, Yale University, 2012

13 Gender Bias: Other Examples Letters for F faculty focused on personal attributes, less respectful (first name!); more objective for M, focused on achievements, more respectful ( Dr. ) Mothers = warmth w/o competence; fathers = warmth w/ competence M = science; F = social sciences Names: Karen vs Lakisha F less likely to be asked to serve as committee chair/ section head/department chair or be involved in decisions re: promotion, space allocation AAMC, 2010

14 Cognitive Science Brain bombarded constantly Processes many inputs (people, situations, known vs. unknown) Fast brain + slow brain Both brains necessary for survival in complex world

15 Fast (Emotional) Brain Survival instincts, rapid associations, emotional responses, flight/fight/freeze, M/F, friend/foe Comfort zone, personal experiences throughout life, conditioned reflexes Gut reactions => decisions without thoughtful or deliberate consideration, just do it Example: CV from top school => let s interview, but CV from lesser school, let s move on

16 Slow (Thinking) Brain Regulates body, balances emotions, calms fears Morality, language, consciousness, rationality Reasoning & insight Fairness, inclusivity Intentionally selective, not reactive Counterbalances fast brain Example: CV from lesser school might be superstar!

17 The Photograph

18 Projection: Fast Brain in Action Reactions to video? If you were photographer? Project association from something/someone reminding of past experience Draw on association to make rapid decision/judgement, negative or positive Example: Phone = talking, texting, games Medical student or resident on phone Neg: goofing off Pos: informational/learning tool

19 Strategies to Mitigate UB Realize biases inherent in all humans Transform culture: Slow down & focus to reduce fast brain Bring to light deeply-seated biases Systematically de-bias (brain can unlearn) Create initiatives to mitigate practices

20 1 st Step to Reduce Bias in Recruitment Pre-training: UB program/readings Foundation for self-awareness, intentional & transparent team-building WARNING: Quite revealing, may be disturbing

21 2 nd Step to Reduce Bias in Recruitment Design framework for desired outcome: Construct list of qualifications of ideal candidate w/ alternative criteria (if needed) Stay on course/protect against bias creep The CV: Name --- blind? Education & training Work history Scholarly record (researcher vs. educator?)

22 3 rd Step to Reduce Bias in Recruitment Number of minority & underrepresented candidates: Ample representation on committee and candidates Agree to preferred target goal for # minority applicants to review to guarantee fair process If fail to achieve, agree sufficient efforts expended The Interview Day: When does day start and end? (travel fatigue) Lecture (Example: audience asking questions, candidate stop interrupting ) Who meeting with during day? Dinner?

23 4 th Step to Reduce Bias in Recruitment Table placement & seating design: Alternate seating arrangements to hinder formation of unconscious power alliances, influence proceedings and decision-making dynamics The Committee: Mix of opinions Biases about clinical skills or research direction Introvert vs. extrovert, interpret in different ways Avoid good fit = bias to keep department/organization as is

24 5 th Step to Reduce Bias in Recruitment Impartial scribe usage: Words and phrases easily and variably interpreted based on preexisting bias Need reliable record to clarify statements expressed or issues dealt with during deliberations

25 Summary: UB in Radiology UB is easy to talk about, but challenging to manage. We must acknowledge that UB exists in each of us, recognize and accept it, and apply de-biasing strategies intentionally and systematically in recruitment process. Mastering UB matters greatly to our advancement to diverse and inclusive work culture.

26 Recommended Readings Allen BJ, Garg K. Diversity Matters in Academic Radiology: Acknowledging and Addressing Unconscious Bias. JACR. 2016;13: Penzias A. Addressing the Elephant in the Room: Implicit Bias in the Health Care Setting. J Radiol Nursing. 2016;35:320. Railey MT, Railey KM, Hauptman PJ. Reducing Bias in Academic Search Committees. JAMA. 2016;316(24): These articles contain additional sources that I also found useful in preparing this talk.